Stoma: Types, Care & Management Guide

What Is a Stoma?

A stoma is a surgically created opening in the abdomen that allows waste to exit the body when the normal digestive or urinary system is disrupted. A stoma is a surgically created opening on the abdominal wall that allows stool or urine to leave the body when the normal pathway is not available. It usually appears moist, red or pink, and similar in appearance to the inside of the mouth lining. that is brought through the abdominal wall and stitched in place.

The stoma itself has no pain sensation because it lacks nerve endings, though the surrounding skin or abdomen may feel sore after surgery. However, they do require specialised care to prevent complications and ensure comfort. Understanding the different types of stomas, proper stoma care techniques, and potential stoma complications can help individuals maintain a healthy and active lifestyle.

Why a Stoma Is Needed?

Several medical conditions may necessitate the creation of a stoma, including:

• Colorectal cancer or bladder cancer
• Inflammatory bowel diseases (e.g., Crohn's disease, ulcerative colitis)
• Diverticulitis
• Bowel obstruction
• Birth defects
• Trauma or injury to the digestive or urinary system
• Ischaemic bowel disease
• Megacolon
• Fistulas or abscesses
• Rectal incontinence due to neurological conditions

Types of Stoma

The main types of stomas are colostomy, ileostomy, and urostomy.: colostomy, ileostomy, and urostomy. Each type serves specific medical purposes and demands distinct care and management.

Colostomy

A colostomy is a type of stoma where the colon (large intestine) is brought through the abdominal wall to allow stool to exit into a colostomy bag. This procedure may be temporary or permanent, depending on the underlying condition.

• Usually performed if the rectum or lower colon is diseased or removed
• Can be located in different parts of the colon (descending, sigmoid, etc.)
• Output is usually more solid and formed.
• May be needed for colon cancer, diverticulitis, trauma, or obstruction

Ileostomy

An ileostomy involves bringing the ileum (last part of the small intestine) to the abdominal surface, bypassing the colon and rectum.

• Stool is typically more liquid or paste-like.
• May be temporary or permanent
• Indicated for conditions like Crohn's disease, ulcerative colitis, familial polyposis, or bowel cancer
• May require more frequent emptying due to higher output volume

Urostomy

A urostomy diverts urine away from a diseased or non-functioning bladder by connecting the ureters to a section of the small intestine, which is then brought to the abdominal wall.

• Used for bladder cancer, birth defects, trauma, or neurological bladder conditions
• Urine collects in a special urostomy pouch.
• Urostomy output is continuous and should generally be clear or light yellow; mucus strands may be present because a piece of intestine is used to create the passage.

Temporary vs. Permanent Stoma

• Temporary stoma: Created to allow healing of the bowel or bladder, often closed in a later stoma surgery when healing is complete.
• Permanent stoma: Required when the affected organ is removed or cannot be repaired.

Stoma Placement and Surgery

Pre-surgery Preparation

Before stoma surgery, patients undergo:

• Comprehensive medical evaluation and imaging
• Discussion with a stoma nurse and stoma site marking
• Bowel preparation (for intestinal stomas)
• Fasting before surgery
• Preoperative education on stoma care and lifestyle changes

Surgical Procedure

The typical steps of a stoma surgery include:

1. Make an incision in the abdomen.
2. Identify and isolate the appropriate part of the intestine or urinary tract.
3. Bring the selected segment through the abdominal wall.
4. Suture the intestine or urinary segment to the skin, creating the stoma.
5. Attach a collection bag or pouch to the stoma.

Post-surgery Recovery

Recovery includes pain management, gradual reintroduction of diet, stoma care education, and emotional support. Most patients receive help from a stoma nurse to learn self-care techniques and manage the new lifestyle, including pouch changes and skin care.

How to Care for a Stoma

Proper stoma care is essential for preventing stoma complications and maintaining skin health around the stoma site.

Cleaning the Stoma

• Wash hands thoroughly before and after care.
• Use warm water and mild, unscented soap to clean the skin around the stoma.
• Gently pat the area dry; avoid rubbing.
• Avoid harsh cleansers, baby wipes, or oily lotions that may interfere with pouch adhesion or irritate skin.

Changing Stoma Bags (Pouches)

1. Gather supplies (new pouch, cleaning items, disposal bag).
2. Wash your hands and gently remove the used pouch.
3. Clean the stoma and surrounding skin.
4. Dry the area completely.
5. Apply a skin barrier (powder, paste, or ring) if there is leakage risk or skin irritation.
6. Attach a new pouch, ensuring a snug fit without gaps.

Preventing Skin Irritation

• Ensure the pouch opening fits closely around the stoma to prevent leaks.
• Change the pouch before it is too full.
• Use skin barrier creams or powders as recommended.
• Avoid adhesives that cause allergic reactions.
• Inspect the skin regularly for redness, rashes, or breakdown.

Recognising Infection Signs

• Redness or swelling around the stoma
• Increased pain or tenderness
• Unusual odour or discharge
• Fever or chills
• Pus or bleeding from the stoma site

Diet and Lifestyle with a Stoma

After a stoma surgery, follow these dietary tips for stoma patients:

• Eat a balanced diet and introduce new foods slowly.
• Drink plenty of fluids to avoid dehydration, especially with ileostomies.
• Initially limit high-fibre and gas-producing foods; most patients can gradually reintroduce them under guidance.
• Chew food thoroughly to prevent blockage.
• Limit foods that cause odour or excessive gas.
• Maintain physical activity as tolerated.
• Wear comfortable, non-restrictive clothing.

Stoma Complications to Watch For

Despite proper care, stoma complications can still occur. Be alert for:

• Skin irritation or breakdown
• Stoma blockage (often from undigested food) or prolapse (stoma telescoping outward)
• Retraction (stoma sinking below skin level)
• Hernia around the stoma site
• Bleeding from the stoma
• Infection at the stoma or skin site
• Leakage from the pouch or around the stoma

Stoma Management Tips

Living with a stoma may feel overwhelming at first, but with the right approach and daily habits, you can manage it comfortably and confidently. Here are some practical stoma management tips to help you care for yourself with ease.

• Empty the pouch when it is one-third to half full to prevent leaks.
• Carry extra supplies when away from home.
• Use odour-control deodorants or filters if needed.
• Apply the pouching system correctly for a good seal.
• Keep track of stoma output and report changes to your healthcare provider.

Living Confidently with a Stoma

Adapting to life with a stoma can feel challenging at first. With time, guidance, and the right support, most people can return to their usual routines, including work, hobbies, travel, and social activities. Learning proper stoma care, choosing the right appliances, and developing a routine can make day-to-day management easier and more comfortable.

Support from stoma care nurses, patient communities, and educational resources can provide reassurance and practical advice. Remember, you are not alone—many people live active, fulfilling lives with a stoma, and you too can face this journey with confidence.

When to See a Doctor

• Persistent redness, swelling, or pain around the stoma
• Signs of infection (fever, discharge, foul odour)
• Sudden changes in stoma size, colour, or output
• Bleeding that does not stop
• Difficulty with pouch changes or leakage
• Symptoms of dehydration (dry mouth, dizziness, low urine output)

Conclusion

A stoma is a significant but often necessary surgical adaptation for people facing certain gastrointestinal or urinary conditions. With proper care, support, and information, most people with stomas can lead active lives. Regular follow-up and attention to stoma health are key to minimising complications and ensuring long-term well-being.

For stoma patients, timely diagnostic tests, such as blood work, urine analysis, or monitoring for infections and nutritional balance, are essential for ongoing care. Metropolis Healthcare supports this journey with a comprehensive portfolio of over 4,000 tests, ranging from routine diagnostics to highly specialised tests. We are proud to be among the top 1% of laboratories worldwide, backed by a CAP proficiency score exceeding 98%, ensuring unmatched accuracy, reliability, and precision. Through our convenient at-home sample collection and secure online report access, we empower you to take control of your health confidently and with ease.

FAQs

1. What is the difference between a colostomy and an ileostomy?

A colostomy connects the colon (large intestine) to the abdominal wall, producing more solid stool. While an ileostomy uses the ileum (last part of the small intestine), resulting in looser, more frequent output.

2. Can a stoma be reversed?

Some stomas are temporary and can be reversed through surgery once the underlying condition has healed. Permanent stomas are not reversible.

3. How long can a stoma last?

A permanent stoma lasts for life. Temporary stomas are intended to be closed after several weeks to months, depending on healing and underlying conditions.

4. What foods should be avoided with a stoma?

Initially, avoid high-fibre foods, tough skins, seeds, nuts, and foods that cause gas or odour. Gradually reintroduce foods while monitoring for any issues. Follow dietary tips for stoma patients provided by your healthcare team.

5. How often should a stoma bag be changed?

Change pouch every 3–7 days depending on type of system and skin condition; drainable pouches may last longer, while high-output stomas may require more frequent changes.

References

• https://www.stomacare.in/stoma-care-guide.php
• https://my.clevelandclinic.org/health/articles/stoma
• https://www.medicalnewstoday.com/articles/stomas#who-needs-it
• https://www.healthline.com/health/stoma